巨大食管裂孔疝是一种特殊类型的食管裂孔疝，其膜解剖结构发生更大的变化，腹腔内容物更多的疝入到胸腔，易与胸膜形成广泛的粘连。巨大食管裂孔疝手术中要保护迷走神经、胃系膜、食管系膜、胸膜，避免出血及各种副损伤，是该手术顺利完成及避免并发症的要点与难点。运用膜解剖理论，更可加深对巨大食管裂孔上膜解剖结构的认识，促进手术顺利完成。本文中笔者运用膜解剖理论在巨大食管裂孔疝手术中的实践，提出个人体会。

Giant esophageal hiatal hernia is a special type of esophageal hiatal hernia. The anatomical structure of the membrane changed more and more of the gastric mesentery herniated into the pleura and had more extensive adhesion to the pleura. The key point and difficulty to successfully complete the operation and avoid complications is to protect the vagus nerve, gastric mesentery, esophageal mesentery and pleura in the operation of giant esophageal hiatal hernia. Using the theory of membrane anatomy, understanding the changes of the anatomical structure of the membrane on the giant esophageal hiatus is the technical key point to successfully complete the operation and avoid injury. In this paper, the author puts forward his personal experience based on the practice of membrane anatomy theory in the operation of giant esophageal hiatal hernia.